Visit http://www.entnet.org/bog&summit for information on registering for the BOG Spring Meeting & OTO Advocacy Summit.
I, the undersigned, hereby apply for a Resident Leadership Grant for the 2013 BOG Spring Meeting & OTO Advocacy Summit. If chosen, I understand and agree to accept the terms of an AAO-HNS/F Leadership Grant. I understand that I am responsible for attending the entire BOG Spring Meeting & OTO Advocacy Summit. If I do not comply with these terms, I will be held responsible for repaying the $350 grant to the AAO-HNS/F. Without a valid reason, non-compliance will preclude my training program from receiving travel grants in the future. I understand this information will be tracked through my membership record.
Receipt of this leadership grant may have some tax implications for you. Therefore, it is recommended that you contact your tax advisor to determine your circumstance before accepting the grant. If awarded a grant, please select how you would prefer to receive it (select only one of the bolded options below):
URGENT: Please email Bethany Clifton (email@example.com) immediately after you apply for this Resident Leadership Grant to make certain we received your application. This is the first we have used this electronic program, and we need to verify that we are receiving all applications. Thank you.